Related Experiment Video
Updated: Jan 16, 2026
Microsatellite DNA Genotyping and Flow Cytometry Ploidy Analyses of Formalin-fixed Paraffin-embedded Hydatidiform Molar Tissues
Published on: October 20, 2019
Addressing Barriers to Autopsy and Genetic Testing in Stillbirth Workup
Karen J Gibbins1, Neeta L Vora1, Akila Subramaniam1
1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon; the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama; and the Department of Obstetrics and Gynecology, Intermountain Health, and the Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah.
Many stillbirths remain unexplained due to barriers in placental pathology, fetal autopsy, and genetic testing workup. Addressing these barriers is crucial for determining stillbirth causes and supporting families.
Area of Science:
- Perinatal Medicine
- Pathology
- Genetics
Background:
- The etiology of stillbirth often remains undetermined, hindering accurate diagnosis and parental understanding.
- Systematic barriers impede comprehensive stillbirth workup, including placental pathology, fetal autopsy, and genetic testing.
- Current autopsy rates in the United States remain low, at only 21% of stillbirth cases.
Purpose of the Study:
- To review the significance of placental pathology, fetal autopsy, and genetic testing in stillbirth investigations.
- To identify existing barriers to thorough stillbirth workup.
- To propose actionable solutions for overcoming these barriers and improving stillbirth investigation.
Main Methods:
- Review of existing literature on stillbirth workup procedures.
- Analysis of the utility of placental pathology and fetal autopsy in determining stillbirth causes.
- Identification of systemic barriers affecting the implementation of comprehensive stillbirth workup.
Main Results:
- Placental pathology is diagnostically useful in 65% of stillbirths.
- Fetal autopsy provides valuable information in 42% of stillbirth cases.
- Significant barriers include costs, lack of expertise, limited healthcare provider knowledge, and inadequate parental counseling.
Conclusions:
- Enhancing stillbirth workup through placental pathology, fetal autopsy, and genetic testing is critical for identifying causes of death.
- Addressing financial, logistical, and educational barriers is essential for increasing the utilization of these diagnostic tools.
- Policy changes and improved patient counseling frameworks are necessary to support bereaved families and improve stillbirth investigation outcomes.
